there are no entry-level education and training requirements for those seeking to practice therapeutic massage. A competent massage therapist must be able to integrate the knowledge of anatomy, physiology, and kinesiology with the hands-on skill of a wide variety of massage therapy techniques. The massage therapist must have high ethical standards, be able to establish boundaries, and provide an environment of physical and emotional safety for the client. A skilled massage therapist must be able to determine what the client’s needs and goals are through professional communication, assessment and documentation, and develop and deliver an appropriate massage session to meet those goals. The massage therapist should be able to recognize various clinical pathologies, understand what conditions are contraindicated for massage, and be confident in refusing service or making referrals to other healthcare providers as needed. All massage therapists, when properly educated and trained, will have acquired this basic knowledge. d. The proposed legislation requires background checks and imposes a statewide disciplinary scheme that will provide a level of confidence with the public that licensed Massage Therapists and Asian Bodywork Therapists have been vetted for prior criminal and disciplinary activities. b. Explain why existing civil or criminal laws or procedures are inadequate to prevent or remedy any harm to the public. Because there is not any uniform statewide regulation. Currently, it is the responsibility of each city to regulate establishment laws for massage therapy and Asian bodywork therapy. Many, but not all cities in Minnesota require this, but those regulations are not consistent. If a practitioner is violating professional ethics there is not a regulatory board to report the practitioner to. This leaves responsibility to the local law enforcement. This also means that a practitioner could have a violation in one city and then practice in another city, or continue to practice. Over the last ten years massage therapy ethical violations have been sighted by law enforcement and made public in franchise massage establishments with multiple locations. In 2020 the Minnesota Office of Higher Education investigated a massage and Asian bodywork school that was cited for human trafficking. c. Explain why the proposed level of regulation has been selected and why a lower level of regulation was not selected. In past years voluntary registration has been proposed. It is not the highest level of regulation needed to ensure public safety. Nationally there are only two states that regulate by voluntary registration. State licensure ensures one regulatory board for enforcement. Questionnaire A – Increased Regulation 8 5) Implications for Health Care Access, Cost, Quality, and Transformation a. Describe how the proposal will affect the availability, accessibility, cost, delivery, and quality of health care, including the impact on unmet health care needs and underserved populations. How does the proposal contribute to meeting these needs? Regulation and licensure of massage therapy will increase the equity and availability of care for clients. Barriers for massage therapists across Minnesota will decrease, in part given an end to the current various requirements, or lack thereof, mandated by local ordinances and rising fees to establish and conduct a business. Because massage therapists practice in multiple settings as noted earlier, massage therapists currently need to register and pay associated fees to numerous municipalities who maintain their own independent, jurisdictional procedures and processes that collectively interfere with the ability to provide uniformity in practice and are an administrative burden to both the practitioner and the municipality. Massage therapy has a growing presence within healthcare. Massage therapy has been singled-out as an effective non-pharmacologic approach to pain management, as shown by a significant body of clinical research, and supported by the National Institutes of Health (NIH), the American College of Physicians, the American Academy of Family Physicians (AAFP) and The Joint Commission. Minnesota’s own Mayo Clinic has joined MD Anderson Cancer Center, Duke Integrative Medicine, the Cleveland Clinic and Memorial Sloan Kettering Cancer Center, among other institutions, in integrating massage therapy into patient care for multiple conditions. These agencies and organizations require or recommend that massage therapists be state licensed. b. Describe the expected impact of the proposal on the supply of practitioners and on the cost of services or goods provided by the occupation. If possible, include the geographic availability of proposed providers/services. Cite any sources used. Licensure should not directly impact the supply of properly trained and educated practitioners. It may impact price in the long-term as the occupation becomes more professionalized and practitioners see it as a long-term career. c. Does the proposal change how and by whom the services are compensated? What costs and what savings would accrue to patients, insurers, providers, and employers? No. The legislation does not change how and by whom services are compensated. d. Describe any impact of the proposal on an evolving health care delivery and payment system (e.g., collaborative practice, innovations in